| ObjectsTo observe the effect of Danzhi Jiangtang Capsule(DJC)on TCM syndrome efficacy,echocardiography and related indexes in patients with type 2 diabetes mellitus(T2DM)complicated with coronary heart disease(CHD),and to explore the model of KLF5(Krüppel-like factor 5),TLR4(Toll-like receptor 4)and aortic pathology intervention,analysis of its mechanism of action,provide new ideas and methods for the treatment of Chinese medicine.Methods 1.Clinical observationUsing random number table method,60 patients who met the inclusion criteria were divided into 30 groups in the control group and the treatment group.The control group was treated with conventional western medicine,the treatment group was treated with DJC on the basis of Western medicine treatment,and 12 weeks was a course of treatment.To observe the efficacy of TCM syndrome before and after treatment,echocardiography,total angina pectoris,fasting blood glucose(FPG),2 hours postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),systolic blood pressure(SBP),diastolic blood pressure(DBP),allergic C-reactive protein(hs-CRP),TLR4,electrocardiogram(ECG)changes in indicators.2.Experimental researchForty healthy male rats were selected and weighed 200±20 g.The normal group was fed with normal diet and the other groups were fed with high fat diet.Four weeks later,intraperitoneal injection of streptozotocin(STZ)35mg/kg was successfully performed with a blood glucose of ?16.7 mmol/l.After successful modeling,the rats were randomly divided into model group,DJC high group,DJC low group and western medicine group.DJC high and DJC low groups were given DJC1.08g/(kg·d)and 0.54g/(kg·d)respectively.The western medicine group was given pioglitazone 10mg/(kg·d).The model group and normal group were given an equal amount of normal saline,and the drug group continued to feed the high fat.Weighed 8 weeks after feeding,blood was taken to measure blood sugar,blood lipids and KLF5,TLR4,while the aorta was taken for pathology.Results 1.Clinical observationAfter treatment,the scores of TCM syndrome and angina pectoris in the two groups were significantly lower than those before treatment(P<0.01),and the treatment group was superior to the control group(P<0.05).The difference between the two groups in the treatment of electrocardiogram was different,the electrocardiogram effect of the treatment group was significantly better than the control group(P<0.05).After treatment,the levels of FPG,2hPG and HbA1 c were significantly lower than those before treatment(P<0.01),the treatment group was better than the control group after treatment(P<0.05).The levels of TG,TC,HDL-C and LDL-C were significantly improved after treatment(P<0.01),and the degree of TC and LDL-C decreased in the treatment group(P<0.01orP<0.05),there was no significant difference in the improvement of TG and HDL-C between the two groups(P>0.05).The levels of SBP and DBP in the two groups were significantly lower than those before treatment(P<0.01).The antihypertensive effect of the treatment group was better than that of the control group(P<0.05).After treatment,the levels of hsCRP and TLR4 in the two groups were significantly lower than those before treatment(P<0.01orP<0.05),there was no significant difference in hs-CRP levels between the two groups(P>0.05).The serum levels of TLR4 in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the echocardiographic indexes of the two groups were improved compared with those before treatment(P<0.01orP<0.05).The comparison between the groups was better than the control group(P<0.05).2.Experimental researchCompared with the model group,the body weight of the drug group increased significantly(P<0.01);compared with the normal group,the blood glucose,HbA1 c,TG,TC,LDL-C levels in the model group were significantly increased(P<0.01);After DJC,the above indicators decreased significantly(P<0.05 or P<0.01).Compared with the normal group,the KLF5 and TLR4 in the model group were significantly increased(P<0.01).Compared with the model group,the above indexes were decreased in the DJC high and DJC low groups(P<0.01orP<0.05).The pathological report showed that the subarachnoid lipid deposition in the aorta of the model group was accompanied by the proliferation of smooth muscle cells and collagen fiber matrix components.After the internal tissue of the plaque was necrotic,it bound with the deposited lipids and gradually formed atherogenic substances.After DJC,the degree of lesions in the high-dose group was significantly reduced,the subendothelium morphology was normal,and the arrangement was neat,with only a small amount of inflammatory cells infiltrating,which was better than the lowdose group and the western medicine group.ConclusionsDJC can effectively alleviate the clinical symptoms of patients with diabetes mellitus complicated with coronary heart disease(stable angina)and improve the relevant indicators of echocardiography,significantly reduce the levels of FPG,2hPG,HbA1 c,TC,LDL-C,SBP,DBP,down-regulate the high expression of hs-CRP and TLR4,improve the quality of life of patients,provide a new idea for the prevention and treatment of T2 DM with CHD.Studies have confirmed that DJC can regulate blood sugar and blood lipids,significantly down-regulate the high expression of KLF5 and TLR4,and inhibit the formation of aortic plaque in diabetic rats. |
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